CHARACTERISTICS, MORTALITY AND RENAL OUTCOMES OF PACIFIC ISLANDER & MAORI PATIENTS WITH DIABETES AND CKD WHO RECEIVE SPECIALIST NEPHROLOGY CARE

K-S TAN1,2,3,  S MCDONALD4,5, W HOY1,2
1NHMRC CKD.CRE and CKD.QLD, Brisbane, Australia, 2Faculty of Medicine, University of Queensland., Brisbane, Australia, 3Renal unit, Logan Hospital & Metro South Health Service, Brisbane, Australia, 4Central and Northern Adelaide Renal And Transplant Service, Adelaide, Australia, 5Adelaide Medical School, University of Adelaide, Adelaide, Australia

Background: Define baseline characteristics, all-cause mortality and renal outcomes of all Pacific Islander/Maori (PI/M) patients with DM and CKD enrolled in the CKD.QLD registry.
Aims: Define baseline characteristics, all-cause mortality and renal outcomes of all Pacific Islander/Maori (PI/M) patients with DM and CKD enrolled in the CKD.QLD registry.
Methods: Diabetic PI/M patients enrolled in the registry between 01/01/2011 and 31/12/2016 were included. Baseline characteristics, incidence of ESKD (eGFR <10ml/min for >3 months or commencement of RRT) or death without ESKD were determined. Censor date was 31/12/2017.
Results: 100 patients (47% women) comprising 4% of all registry patients with DM identified as PI/M .  Mean follow up was 2.87 years. Mean age at enrolment was 60.6y (SD 11.5), significantly younger than non-ATSI, non-PI/M counterparts with DM (mean age 67, p<0.001). 61% of patients were incident (enrolled within 6 months of 1st appointment). 99% had DM2 (56% receiving insulin).  Median eGFR at enrolment was 38ml/min (IQR 25-53). 60% had enrolment eGFR <45ml/min. 57% had ACR >30mg/mmol at enrolment.  At censor date, 30 patients had developed ESKF (5 on supportive care, 25 commenced dialysis) whilst 14 had died without ESKF. ESKF rate was 27.5 and death rate 16.4 per 100 patient years follow-up. 100% of ESKF patients had ACR >30mg/mmol at enrolment although enrolment ACR category was not associated with development of ESKF in a multivariate regression model.
Conclusions: As befits a group receiving specialist renal care, patients had both significantly reduced eGFR and significant albuminuria at enrolment. The event rate was high.


Biography:
Nephrologist and Clinical Pharmacologist.

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